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Men under 50 and over 69 and those with a limited life expectancy should not be screened for prostate cancer, according to new guidelines issued by the American College of Physicians. The group called on providers to discuss with their male patients the limited benefits and "substantial" risks associated with the prostate-specific antigen test. "By and large, the data doesn't support routine screening because the outcomes aren't better," said Dr. David Bronson, president of the ACP.

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Many providers don't follow guidelines recommending that men older than 75 not be screened for prostate cancer, according to a study published in the Journal of the American Medical Association. Researchers looked at Medicare data on more than 61,000 patients and nearly 2,000 primary care providers and found that about 41% of men aged 75 and older with no history of prostate cancer received prostate-specific antigen screening and nearly 29% were screened with PSA tests ordered by their primary care providers. The rates fell with patient age.

Medicare records of more than 23,000 prostate cancer patients revealed that black men waited seven days longer, on average, to start treatment following their diagnosis compared with white men. Black patients were less likely to be screened for prostate cancer and had a higher risk of being diagnosed with an advanced form of the disease than whites, researchers reported in the journal Cancer.

The American Urological Association revised its stance on prostate cancer screenings to recommend against performing all routine prostate-specific antigen-based screening for prostate cancer, as well as all screening in men older than 70, younger than 40 and those ages 40 to 54 at average risk. The reversal brings the AUA more into agreement with the AAFP and the U.S. Preventive Services Task Force in recommending against all routine prostate-specific antigen-based screenings.

Men under 50 and over 69 and those with a limited life expectancy should not be screened for prostate cancer, according to new guidelines issued by the American College of Physicians. The group called on providers to discuss with their male patients the limited benefits and "substantial" risks associated with the prostate-specific antigen test. "By and large, the data doesn't support routine screening because the outcomes aren't better," said Dr. David Bronson, president of the ACP.

Annual screening for prostate cancer using prostate-specific antigen testing adds an average of three healthy weeks to a man's life, but the net benefit or harm depends on the individual's tolerance for possible side effects, a study published in New England Journal of Medicine found. Screening men in their late 50s and 60s would prevent nine cancer deaths per 1,000 men, but there would be 247 extra negative biopsies performed and 45 cancers overdiagnosed, the study found. Treatment for prostate cancer can cause erectile dysfunction, urinary incontinence and chronic diarrhea, and some prostate cancers will never cause symptoms or threaten lifespan.